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在3个月或6个月时,阳性椎间盘与颈椎前路椎间盘切除融合术后的沉降无关。

Positive Intervertebral Discs Are Not Associated with Subsidence Following Anterior Cervical Discectomy and Fusion at 3 or 6 Months.

作者信息

Camacho Jael, Carbone Jake, Suresh Rohan I, Khanna Shivam, Ye Ivan B, Thomson Alexandra E, Bruckner Jacob, Gopinath Rohan, McGowan Shane, O'Hara Nathan, Bivona Louis J, Jauregui Julio J, Cavanaugh Daniel L, Koh Eugene Y, Ludwig Steven C

机构信息

Division of Spine Surgery, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA.

出版信息

J Clin Med. 2024 Sep 22;13(18):5619. doi: 10.3390/jcm13185619.

Abstract

(), formerly known as (), is an anaerobic, low-virulent bacterium that has been associated with postoperative infections of the shoulder, knee, and cervical spine. Recent studies have highlighted an association between and the development of degenerative disc disease (DDD). The aim of this study is to ascertain whether increases the risk of subsidence following anterior cervical discectomy and fusion (ACDF). After IRB approval, consecutive patients undergoing elective ACDF for DDD from 2017 to 2018 were enrolled in this prospective cohort study. Intervertebral disc samples were taken at each affected level and cultured. A total of 66 patients with radiographic follow-ups were included in the final analysis. The extent of subsidence and cervical lordosis was determined immediately postoperatively and at the 3- and 6-month follow-ups. No significant difference in subsidence was observed at 3 months ( = 0.07) or 6 months ( = 0.11) between culture-positive and -negative cohorts. Additionally, there was no significant difference detected in the change in cervical lordosis observed at 3 months ( = 0.16) or 6 months ( = 0.27) between culture-positive and -negative cohorts. For the most inferiorly fused segment, there was a significant difference in subsidence observed at 3 months (1.5 mm, 95% CI: 0.2-2.7 mm, = 0.02) but not at 6 months ( = 0.17). Intervertebral discs with a positive culture were not associated with greater levels of subsidence at 3 or 6 months following ACDF for DDD. Further research is necessary to endorse these results and to gauge the clinical significance of infection.

摘要

(),原名为(),是一种厌氧、低毒力细菌,与肩部、膝部和颈椎的术后感染有关。最近的研究强调了()与椎间盘退变疾病(DDD)发展之间的关联。本研究的目的是确定()是否会增加颈椎前路椎间盘切除融合术(ACDF)后下沉的风险。经机构审查委员会(IRB)批准,2017年至2018年因DDD接受择期ACDF的连续患者被纳入这项前瞻性队列研究。在每个受影响节段采集椎间盘样本并进行培养。最终分析纳入了66例有影像学随访的患者。术后即刻以及3个月和6个月随访时确定下沉程度和颈椎前凸情况。培养阳性和阴性队列在3个月(P = 0.07)或6个月(P = 0.11)时下沉情况无显著差异。此外,培养阳性和阴性队列在3个月(P = 0.16)或6个月(P = 0.27)时观察到的颈椎前凸变化也无显著差异。对于最下方融合节段,3个月时下沉有显著差异(1.5毫米,95%可信区间:0.2 - 2.7毫米,P = 0.02),但6个月时无差异(P = 0.17)。DDD行ACDF术后3个月或6个月时,()培养阳性的椎间盘与更高程度的下沉无关。需要进一步研究来证实这些结果并评估()感染的临床意义。

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